Lowe V J, Fletcher J W, Gobar L, Lawson M, Kirchner P, Valk P, Karis J, Hubner K, Delbeke D, Heiberg E V, Patz E F, Coleman R E
Department of Nuclear Medicine, St Louis University Health Sciences Center, MO 63110-0250, USA.
J Clin Oncol. 1998 Mar;16(3):1075-84. doi: 10.1200/JCO.1998.16.3.1075.
Solitary pulmonary nodules (SPNs) are commonly identified by chest radiographs and computed tomography (CT). Biopsies are often performed to evaluate the nodules further. An accurate, noninvasive diagnostic test could avoid the morbidity and costs of invasive tissue sampling. We evaluated the ability of fluorine-18 deoxyglucose positron emission tomography (FDG-PET) to discriminate between benign and malignant pulmonary nodules in a prospective, multicenter trial.
Eighty-nine patients who had newly identified indeterminate SPNs on chest radiographs and CT were evaluated with FDG-PET. PET data were analyzed semiquantitatively by calculating standardized uptake values (SUVs) as an index of FDG accumulation and also by a visual scoring method. PET results were compared with pathology results.
Sixty SPNs were malignant and 29 were benign. Using SUV data, PET had an overall sensitivity and specificity for detection of malignant nodules of 92% and 90%. Visual analysis provided a slightly higher, but not statistically significant, sensitivity of 98% and lower specificity of 69%. For SPNs < or = 1.5 cm (34 of 89), the sensitivity and specificity of SUV and visual analysis were 80% and 95% and 100% and 74%, respectively.
FDG-PET can accurately characterize indeterminate SPNs. PET imaging provides a noninvasive method to evaluate indeterminate SPNs, which can reduce the need for invasive tissue biopsy.
孤立性肺结节（SPN）通常通过胸部X线片和计算机断层扫描（CT）发现。常需进行活检以进一步评估这些结节。一种准确的非侵入性诊断测试可避免侵入性组织取样带来的发病率和成本。我们在一项前瞻性多中心试验中评估了氟-18脱氧葡萄糖正电子发射断层扫描（FDG-PET）区分良性和恶性肺结节的能力。
89例胸部X线片和CT新发现的不确定SPN患者接受了FDG-PET评估。通过计算标准化摄取值（SUV）作为FDG积聚指标对PET数据进行半定量分析，并采用视觉评分法。将PET结果与病理结果进行比较。
60个SPN为恶性，29个为良性。利用SUV数据，PET检测恶性结节的总体敏感性和特异性分别为92%和90%。视觉分析的敏感性略高，为98%，但无统计学意义，特异性较低，为69%。对于直径≤1.5 cm的SPN（89个中的34个），SUV和视觉分析的敏感性和特异性分别为80%和95%以及100%和74%。
FDG-PET能够准确地对不确定的SPN进行特征描述。PET成像提供了一种评估不确定SPN的非侵入性方法，可减少侵入性组织活检的需求。
